Premium
The Impact of Insurance Coverage on Utilization of Prescription Contraceptives: Evidence from the Affordable Care Act
Author(s) -
Becker Nora V.
Publication year - 2018
Publication title -
journal of policy analysis and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.898
H-Index - 84
eISSN - 1520-6688
pISSN - 0276-8739
DOI - 10.1002/pam.22064
Subject(s) - medical prescription , mandate , medicine , pill , health care , patient protection and affordable care act , family planning , health insurance , sterilization (economics) , family medicine , business , environmental health , population , economic growth , finance , economics , nursing , political science , law , exchange rate , research methodology , foreign exchange market
Abstract The Affordable Care Act (ACA) mandates that prescription contraceptives be covered by private health insurance plans with no cost sharing. Using medical and prescription claims from a large national insurer, I estimate individual claim rates and out‐of‐pocket (OOP) costs of prescription contraceptives for 329,642 women aged 13 to 45 who were enrolled in private health insurance between January 2008 and December 2013. I find that OOP spending on contraceptives has decreased sharply since the implementation of the ACA mandate. Using a difference‐in‐difference model that leverages employer‐level variation in compliance with the mandate, I estimate the effect of the mandate on use of both short‐ and long‐term methods of prescription birth control. I find that the mandate has increased insurance claims for short‐term contraceptive methods (the pill, patch, ring, shot, diaphragms/cervical caps, and prescription emergency contraception) by 4.8 percent and increased initiation of long‐term methods (intrauterine devices, implant, or sterilization) by 15.8 percent. Using data from a national survey of reproductive age women during this same time period, a back‐of‐the‐envelope calculation suggests that the mandate increased total use of any method of prescription contraceptive use by 2.95 percentage points among privately insured women in 2013, or a 6.57 percent relative increase. These increases in use of prescription contraceptives among privately insured women in the United States as a result of the ACA mandate have important potential implications for fertility rates, health care spending, and economic outcomes for women and their families.